[A fistula between the coronary artery and peripheral branches of the pulmonary artery: a case report].

Coronary artery fistulas are occasionally found in patients who undergo a coronary angiography and they may involve any epicardial coronary artery; the natural history in asymptomatic adult patients is unknown. Besides the invasive diagnosis with cardiac catheterization, it is possible to detect significant coronary fistulas also with different non-invasive methods, but they need the presence of shunt of enough size. Therapeutic options can be surgical or percutaneous. The demonstration of a communication between the coronary and distal tract of the pulmonary artery is difficult to explain with the embryogenic theory. We report the case of a patient with aortic stenosis and a shunt between the distal tract of the left pulmonary artery and the circumflex coronary artery.